FACTORS INFLUENCING NUTRITION EDUCATION FOR PATIENTS WITH LOW-LITERACY SKILLS

Although there has been increasing attention to cancer prevention amon g low-income and minority populations, only a few nutrition interventi ons have addressed the special needs of people with low literacy skill s. To determine the best provider and the most effective format for a nutrition intervention targeting patients with low Literacy skills, we conducted interviews with literacy experts and health care providers and focus groups with members of adult basic education classes. Thirty -five literacy experts and health-center-based physicians, nurses, and nutritionists in Boston, Mass, were interviewed. In addition, 50 volu nteer clients from 4 Boston-based adult basic education programs parti cipated in 6 focus groups. Results suggested that health care provider s consider nutrition to be a fundamental health education topic, but t hat its successful inculcation in patients with limited literacy skill s is hindered mostly by insufficient provider time. Almost all provide rs agreed that patients need to be referred to nutritionists for nutri tion education. Although most providers and patients acknowledged that patients perceive physicians to be the authorities on health, patient s with low literacy skills turned first to family members and friends for health information. These results suggest that effective nutrition interventions must build on patients' social networks; appear in a vi sually based, interactive format; and be culturally appropriate.